The Medicare Supplement (Medigap) Birthday Rule is a state law that lets you switch Medigap plans or carriers once a year around your birthday without medical underwriting. As of September 2026, 15 states have a birthday rule, and one more state is pending to start in 2027.
If you live in one of these states, then you may benefit and save on premiums as carrier premiums fluctuate from year to year. Find out more information on the birthday rule, whether your state participates, and how you can benefit from making a change.
What exactly is the Medigap Birthday Rule?
Traditionally, you have one opportunity to enroll in a Medicare Supplement (Medigap) plan without underwriting: this is during your Open Enrollment Period. If you want to change plans any time after this, carriers typically require underwriting. This means you may not pass underwriting if you have serious health issues.
This differs from Medicare Advantage plans, which allows you to change every year during the Annual Election Period. This is because Medicare Advantage plans are regulated by the federal government. To address the unfair opportunity that Medicare Advantage enrollees have over Medicare Supplement enrollees, many states have passed legislation known as a the “Birthday Rule”. This trend has gained traction!
How the Medicare Supplement Birthday Rule varies by state
Not all state Birthday Rules are the same! They can vary based on whether they let you change plans, change insurance carriers, or both. Each of these scenarios can potentially help you save. Let’s breakdown each on to see how it can affect your premiums.
Birthday Rules that only allow you to change plans
If your state only allows you to change plans and not carriers, then this means you have to stay with the same carrier but you can pick a plan with lesser benefits. For example, if you have Plan F that has become increasingly more expensive then you can move to Plan G or Plan N to save on premiums. You do have to stay with the same carrier (or sometimes affiliates) though. This can still save you money each month even though you are giving up some coverage.
Birthday Rules that only allow you to change insurance companies
You may wonder why you would change insurance companies if you can’t change your plan. Premiums are based on several factors that can vary by company. This includes overall claims, as well as the plan risk pool. If a carrier has more claims or their risk pool is collectively unhealthy or aging, then they may offset this with higher premiums. Because of this, premiums for the same plan can vary between carriers. And this variation can change each year! Plan G with one company can be more expensive than the exact same Plan G with another company. This is why it is important to compare rates across carriers.
Birthday Rules that allow you to change BOTH your plan AND your insurance company
This scenario is really the best of both worlds. In this situation, you can change your plan, your insurance company, or both each year. However, if you change to a new plan it must be of lesser coverage. This means you can go from Plan F to Plan G, or Plan G to Plan N, or even a bigger jump from Plan F to Plan N if you want. You just cannot move up the plan chain to get better coverage without underwriting.
How can I benefit from changing plans or carriers?
Medicare Supplement premiums continue to increase year-after-year. They also fluctuate from one company to another depending on the risk pools (the group of insured beneficiaries in a plan). Fluctuation between carriers means that another carrier may offer your exact plan at a lower premium. This is one way to potentially save.
Another factor is your current plan coverage level. Some people enroll in the Medicare Supplement with the most coverage when they first turn 65 (i.e. Plan F or Plan G). This is usually due to lower initial premiums when your are younger. But as you age, premiums increase and can get expensive. This is especially true when the government discontinues a specific Medigap plan. Plan J, F, and C are discontinued plans that are getting excessively expensive because the risk pool is getting smaller and older. Switching to a different plan could lower your premium without giving up too much coverage.
States that have a Medicare Supplement Birthday Rule
Check out the chart below to see the current states with Birthday Rules. The chart details what plans you change and when for each state. This chart is accurate as of 09/28/2026. For more updated information, be sure to reach out to our licensed agents for help!
| State | Birthday Rule | What can you switch? | When Can you Switch? |
|---|---|---|---|
| California | Yes | You can change carriers and plans with equal or a lesser benefits as your current plan. | 60 days from first day of birthday month. |
| Delaware | Yes | You can change carriers and plans with equal or a lesser benefits as your current plan. | 30 days before and up to 30 days after their birthday. |
| Idaho | Yes | You can change carriers and plans with equal or a lesser benefits as your current plan. | 63 days from your birthday. |
| Illinois | Yes | You can change plans with equal or lesser benefits from the same carrier (or affiliates). | 45 days from your birthday. Only applies if you are 65-75 years old. |
| Indiana | Yes | You can change carriers to a plan with the same benefits. | One month before your birthday and ends one month after your birthday. |
| Kentucky | Yes | You can change carriers to a plan with the same benefits. | Within 60 days of your birthday. |
| Louisiana | Yes | You can change plans with equal or lesser benefits from the same carrier. | 63 days from your birthday. |
| Maryland | Yes | You can change carriers and plans with equal or lesser benefits as your current plan. | 30 days from your birthday. |
| Nevada | Yes | You can change carriers and plans with equal or lesser benefits as your current plan. | 60 days from first day of birthday month. |
| New Mexico | Yes | Starting 2027: You can change carriers and plans with equal or lesser benefits as your current plan. | 60-day window starting on the first day of your birthday month. |
| Oklahoma | Yes | You can change carriers and plans with equal or lesser benefits as your current plan. | 60 days from your birthday |
| Oregon | Yes | You can change carriers and plans with equal or lesser benefits as your current plan. | 30 days from first day of birthday month. |
| Utah | Yes | You can change plans with equal or lesser benefits from the same carrier. | 60 days from your birthday. |
| Virginia | Yes | You can change carriers to a plan with the same benefits. | 60 days from your birthday |
| West Virginia | Yes | Change to a plan with equal or lesser value from same carrier or affiliated company. | 60 days from first day of birthday month. Must have had the same Medigap policy for 2 years before eligible for change. |
| Wyoming | Yes | Change to a plan or carriers with similar or lesser coverage. | Within 63 days after birthday. |
States that are considering Birthday Rule legislation
The Birthday Rule is a growing trend that other states consider on and off each year. If you are in the state below, then keep an eye on your state legislation to see if it passes. Just because they are considering legislation, doesn’t guarantee it will pass. Last year, several other state initiatives failed. However, keep checking your state because many of them have shelved initiatives and bring them back around in later years.
- Pennsylvania
What if I don’t live in a state that allows plan changes each year?
Just because you do not live in a state with a Birthday Rule, does not mean you are 100% out of luck. You can technically enroll in or change Medicare Supplement plans anytime of the year. The difference is that you would have to go through underwriting. If you are relatively healthy, then this is not an issue and you can change to a different plan or carrier to save. A licensed agent can help you determine if you have a good chance of passing underwriting. Most carriers do not require an application fee to apply and go through underwriting. If you are unsure, then pick a carrier that doesn’t have a fee to apply.
If you cannot pass underwriting but need to save money, then it may be a good time to explore other affordable coverage options. Medicare Advantage can offer affordable coverage as many plans have $0 premium. These plans still cover everything that Medicare covers, but can also include additional benefits. Learn the difference between Medicare Supplements and Medicare Advantage plans here!
Medicare can be complicated and difficult to keep up with all these rule changes! We have licensed agents in most states and can help you navigate plans. You can schedule a convenient appointment for FREE assistance here.
Frequently Asked Questions
The Medigap birthday rule is a state law that give you an annual enrollment window to switch Medicare Supplement (Medigap) plans, carriers, or both once a year around your birthday.
As of September 2026, the states with a birthday rule are California, Delaware, Idaho, Illinois, Indiana, Kentucky, Louisiana, Maryland, Nevada, Oklahoma, Oregon, Utah, Virginia, West Virginia, and Wyoming. New Mexico’s rule begins in 2027. Pennsylvania is considering similar legislation.
The amount of time depends on the state. However, the enrollment windows range from about 30 days to 63 days around your birthday month. For example, Maryland’s is 30 days, but California, Nevada, and Utah’s are 60 days. You should check with your state’s legislation.
No. Every state has a variation on which plan or carriers you can switch, but none of them allow you to increase your coverage. You can only change to a plan with equal or lesser benefits.
This depends on the state. Some states only allow you to change to a new plan with the same carrier. Other state let you change plans and carriers.
No. The Birthday Rule is a guarantee issue and does not allow the carriers to ask health related questions. They cannot deny you based on health.
Yes, some states have restrictions on who can make a change. These can be based either age, length of current Medigap plan, or no gaps in coverage over 60 days. For example, West Virginia requires you to have your current Medigap plan for at least 2 years before you qualify.
Carrier Medicare supplement rates can vary each year based on many factors, including age, claim and health of their risk pool. If your premiums have continued to rise each year, there may be another carrier or lesser benefit plan that can save you money.
If your state does not have a birthday rule, you can still change your Medigap plan at any time but you have to go through underwriting. This means you could be denied if you have a lot of health issues.
Eric is a licensed agent specializing in helping Medicare beneficiaries navigate Medicare. He educates and assists beneficiaries with Medicare enrollment, coverage options, timelines, costs, and more.
